[老年人的跨学科疼痛治疗]。

Peter Mattenklodt, Anne Ingenhorst, Brigitta Flatau, Kristina Becker, Norbert Grießinger
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引用次数: 0

摘要

老年人的慢性疼痛正变得越来越重要,并对健康造成严重影响。因此,国际指南要求对老年人的疼痛治疗最好是基于生物-心理-社会疼痛模型的多模式疗法。跨学科疼痛评估有专门的心理测试和访谈指南。有关老年人多模式疼痛疗法有效性的证据仍然有限。不过,对照临床试验表明,这些患者可以从中受益,特别是如果干预措施适合他们的特殊需求。运动疗法的重点不仅是肌肉强化,还包括协调练习。在个体物理疗法和职业疗法中,可以针对老年期更常见的个体身体限制制定日常解决方案。在心理治疗中,接受疼痛、平衡休息和活动、融入社会和应对衰老是特别重要的主题。放松和正念技巧也能对疼痛和功能产生有利影响。因此,这些方法很受患者欢迎,在日常疼痛管理中经常被采用。疼痛教育被认为是一种有用的辅助措施,在老年人中也越来越多地得到数字媒体的支持。辅助治疗包括对恐惧-回避信念的对抗性治疗(德国 AMIKA 量表,Ältere Menschen in körperlicher Aktion,"老年人的身体行动")和作为积极自助策略的自然疗法应用。由于尚不清楚所取得的治疗效果能持续多久,因此后续护理对老年患者的治疗尤为重要。
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[Interdisciplinary pain therapy in the elderly].

Chronic pain in the elderly is becoming increasingly important and is associated with serious health impacts. Therefore, international guidelines demand that pain therapy for the elderly preferably be a multimodal therapy based on a bio-psycho-social pain model. Specific psychometric tests and interview guidelines are available for the interdisciplinary pain assessment. Evidence for the effectiveness of multimodal pain therapy in the elderly remains limited. However, controlled clinical trials have shown that these patients benefit-especially if the intervention is adapted to their specific needs. The focus of movement therapy is not only muscle strengthening but also coordination exercises. In individual physical therapy and occupational therapy, everyday solutions can be developed for individual physical limitations that are more frequent in old age. In psychological training, pain acceptance, balancing rest and activity, social integration and dealing with aging are particularly important topics. Relaxation and mindfulness techniques can also favorably affect pain and function. Thus, these are popular with patients and are often adopted in everyday pain management. Pain education is considered useful as an adjunctive measure and can also be increasingly supported by digital media in the elderly. Complementary therapy components include confrontational treatment of fear-avoidance beliefs (the German AMIKA scale, Ältere Menschen in körperlicher Aktion, "older people in physical action") and naturopathic applications as an active self-help strategy. Since it is unclear how long the achieved therapeutic effects last, follow-up care is of particular importance in therapy for older patients.

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